ROLE OF FUNGI IN COVID-19 PATIENTS WITH CHRONIC LUNG DISEASE IN RANI DURGAVATI MEDICAL COLLEGE, BANDA (FORMERLY GOVERNMENT ALLOPATHIC MEDICAL COLLEGE, BANDA 210001 (UP) INDIA.)

Background: Fungal infections of the lung have gained increasing recognition in the field of infectious disease and they are difficult to diagnosis. Advances in modern treatment like antibiotics corticosteroids, Immunosupressants and anticancer drugs have lead to increase in opportunistic fungal infections including bronchopulmonary Candidiasis and Bronchopulmonary aspergillosis has also increased, commonly occurs in COVID-19 patients of pre existing bronchial asthma. In India there is high prevalence of chronic lung diseases including bronchial Asthma, yet the diagnosis of aspergillosis and Candidiasis. An association between asthma and aspergillosis was noted and confirmed by isolation of Aspergillus species more commonly in sputum of Asthma patients (Lum et al., 2020 Singla, N. et al., 2019). Subject and Methods: To find out the role of fungi in 50 Corona virus (RTPCR test) positive patients of chronic lung disease (non tubercular) like COPD, Chronic Bronchitis with or without emphysema, Broncheichtasis, Bronchial Asthma were included. Patients were attended and admitted in Rani Durgavati Medical College (RDMC) and Hospital, Banda (UP) India, in a one year period was taken up from December 2020 till December 2021. The diagnosis of these cases v/as established by clinical features, radiological examination of chest, ECG, pulmonary function tests. Laboratory procedure for isolation and identification of fungi in bronchoalveoiar lavage. Each specimen of Bronchoalveloar Lavage (BAL) was subjected to various laboratory procedures for isolation and identification of fungi. Result: Different fungal species were cultured in 26% total cases. 20% isolates were positive for fungi alone whereas rest 6% cases showed both bacterial and fungal pathogens amongst fungi Candida was the predominant isolate in 16% cases followed by Aspergillus in 8% cases and Histopfasms capsulatum in just1(2%) case. Fungal isolates in bronchial aspirates were sensitive to Amphotericin B, Fluconazole, etc. Conclusion: COVID-19 Patients which are already containing chronic lung diseases especially COPD, bronchiectasis is more common in elderly males. The Bronchiectatic patients are also at risk of getting, fungal infections Patients of chronic lung disease who are on long-term antibiotic therapy, and or steroids are more predisposed to get these opportunistic infections. Another conclusion from it is clear that there is great need better and judicious use of antibiotics in patients to prevent drug resistance, to prevent further progression of the diseases.